Intrauterine
Insemination is
Often Used for Cerivcal
Factor Infertility

Intrauterine
Insemination (IUI)

Intrauterine
insemination (IUI) is often a
first choice for infertility treatment in women who are not
ovulating regularly, have cervical disease, produce antibodies
to the male's sperm (low incidence) or where the male partner
has mild infertility. IUI might be an option for you dependent
upon the cause(s) of your infertility.

When
moderate to severe male factor is present, tubal damage exists,
severe endometriosis is present, or the female is older than
thirty-five, in vitro fertilization is usually the recommended
treatment.

In
IUI, sperm are inserted through the cervix into the uterus
using a small catheter. This avoids problems with inadequate
cervical mucus since the sperm do not have to swim through
the vagina to the uterus. Sometimes a woman may produce antibodies
to the male's sperm which will cause their destruction. IUI
also avoids the exposure to potential female antibodies in
the vaginal or cervical fluid.

Women
often receive ovulation induction medications such as follicle
stimulating hormone (FSH) to cause ovulation and the development
of many follicles, each of which contains one egg. These drugs
must only be used by a trained fertility specialist familiar
with monitoring and dosage adjustment.

The
specialist carefully follows each patient, making dosage adjustment
as necessary, to avoid potentially serious side effects and
multiple births. Most cases of high order multiple births
(triplets or higher) result from IUI cycles that were administered
by a non specialist.

Follicular
development is monitored using transvaginal ultrasound and
measurement of estrogen levels. Estrogen levels rise as healthy
follicles development. An injection of hCG is given thirty
six hours prior to the scheduled insemination.

The
male partner provides a sperm sample by masturbation, which
is specially prepared (washed) and concentrated. In cases
where the male has moderate to severe infertility a sperm
donor may be used. This semen is supplied as a frozen sample
which must be thawed.

The
sperm are loaded into a small catheter which is gently inserted
directly into the uterus. Some lay material refers to couples
performing inseminations without the aid of a health care
professional using unprepared sperm. This can cause serious,
even fatal, allergic reactions and sho
uld
never be attempted.

The
pregnancy rate per cycle using FSH or HMG (gonadotropins)
with IUI is approximately 20-25% for females less than 35
years old. Most couples who will conceive with this method
will do so by three cycles. If pregnancy does not occur, in
vitro fertilization (IVF) is the next step in treatment.